How much rates vary
Facilitymedian $23 · 10th to 90th $9 to $69Professionalmedian $9 · 10th to 90th $9 to $16
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $8.71 Median $11.22 Typical High $18.62 | Facility | None | $8.71 | $11.22 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | None | $8.71 | $8.71 | $8.91 |
BCBS Texas Setting Facility Modifier None Typical Low $15.85 Median $38.90 Typical High $74.13 | Facility | None | $15.85 | $38.90 | $74.13 |
BCBS Texas Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $16.22 Typical High $27.54 | Facility | None | $8.71 | $16.22 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Lucent Health Setting Professional Modifier None Typical Low $9.12 Median $10.23 Typical High $16.22 | Professional | None | $9.12 | $10.23 | $16.22 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $10.47 Typical High $17.78 | Facility | None | $8.71 | $10.47 | $17.78 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Professional | None | $8.71 | $8.71 | $8.91 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $9.12 | Professional | None | $7.94 | $7.94 | $9.12 |
Oscar Health Setting Professional Modifier None Typical Low $7.76 Median $15.14 Typical High $31.62 | Professional | None | $7.76 | $15.14 | $31.62 |
Providence Setting Facility Modifier None Typical Low $8.71 Median $12.30 Typical High $74.13 | Facility | None | $8.71 | $12.30 | $74.13 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
United Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $9.77 | Professional | None | $8.71 | $9.12 | $9.77 |
Wellpoint Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $4.37 Median $5.62 Typical High $9.33 | Facility | 52 · Reduced service | $4.37 | $5.62 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $2.24 Typical High $3.72 | Facility | 53 · Discontinued | $1.74 | $2.24 | $3.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.29 Median $1.70 Typical High $2.82 | Facility | 55 · Aftercare only | $1.29 | $1.70 | $2.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.12 Typical High $1.86 | Facility | 56 · Pre-op care only | $0.87 | $1.12 | $1.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.37 Median $4.37 Typical High $4.47 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.32 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.89 |
Where Texas sits
The same service costs 1.9 times more in Wyoming than in Mississippi. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 25th of 51
$8.71
WY $16.22MS $8.71
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.